PeerJ:Pediatricshttps://peerj.com/articles/index.atom?journal=peerj&subject=6200Pediatrics articles published in PeerJHuman milk microbiota associated with early colonization of the neonatal gut in Mexican newbornshttps://peerj.com/articles/92052020-05-222020-05-22Karina Corona-CervantesIgrid García-GonzálezLoan Edel Villalobos-FloresFernando Hernández-QuirozAlberto Piña-EscobedoCarlos Hoyo-VadilloMartín Noé Rangel-CalvilloJaime García-Mena
Background
Human milk microbiota plays a role in the bacterial colonization of the neonatal gut, which has important consequences in the health and development of the newborn. However, there are few studies about the vertical transfer of bacteria from mother to infant in Latin American populations.
Methods
We performed a cross-sectional study characterizing the bacterial diversity of 67 human milk-neonatal stool pairs by high-throughput sequencing of V3-16S rDNA libraries, to assess the effect of the human milk microbiota on the bacterial composition of the neonate’s gut at early days.
Results
Human milk showed higher microbial diversity as compared to the neonatal stool. Members of the Staphylococcaceae and Sphingomonadaceae families were more prevalent in human milk, whereas the Pseudomonadaceae family, Clostridium and Bifidobacterium genera were in the neonatal stool. The delivery mode showed association with the neonatal gut microbiota diversity, but not with the human milk microbiota diversity; for instance, neonates born by C-section showed greater richness and diversity in stool microbiota than those born vaginally. We found 25 bacterial taxa shared by both ecosystems and 67.7% of bacteria found in neonate stool were predicted to originate from human milk. This study contributes to the knowledge of human milk and neonatal stool microbiota in healthy Mexican population and supports the idea of vertical mother-neonate transmission through exclusive breastfeeding.

Background

Human milk microbiota plays a role in the bacterial colonization of the neonatal gut, which has important consequences in the health and development of the newborn. However, there are few studies about the vertical transfer of bacteria from mother to infant in Latin American populations.

Methods

We performed a cross-sectional study characterizing the bacterial diversity of 67 human milk-neonatal stool pairs by high-throughput sequencing of V3-16S rDNA libraries, to assess the effect of the human milk microbiota on the bacterial composition of the neonate’s gut at early days.

Results

Human milk showed higher microbial diversity as compared to the neonatal stool. Members of the Staphylococcaceae and Sphingomonadaceae families were more prevalent in human milk, whereas the Pseudomonadaceae family, Clostridium and Bifidobacterium genera were in the neonatal stool. The delivery mode showed association with the neonatal gut microbiota diversity, but not with the human milk microbiota diversity; for instance, neonates born by C-section showed greater richness and diversity in stool microbiota than those born vaginally. We found 25 bacterial taxa shared by both ecosystems and 67.7% of bacteria found in neonate stool were predicted to originate from human milk. This study contributes to the knowledge of human milk and neonatal stool microbiota in healthy Mexican population and supports the idea of vertical mother-neonate transmission through exclusive breastfeeding.

Early language competence, but not general cognitive ability, predicts children’s recognition of emotion from facial and vocal cueshttps://peerj.com/articles/91182020-05-122020-05-12Sarah GriffithsShaun Kok Yew GohCourtenay Fraiser Norbury
The ability to accurately identify and label emotions in the self and others is crucial for successful social interactions and good mental health. In the current study we tested the longitudinal relationship between early language skills and recognition of facial and vocal emotion cues in a representative UK population cohort with diverse language and cognitive skills (N = 369), including a large sample of children that met criteria for Developmental Language Disorder (DLD, N = 97). Language skills, but not non-verbal cognitive ability, at age 5–6 predicted emotion recognition at age 10–12. Children that met the criteria for DLD showed a large deficit in recognition of facial and vocal emotion cues. The results highlight the importance of language in supporting identification of emotions from non-verbal cues. Impairments in emotion identification may be one mechanism by which language disorder in early childhood predisposes children to later adverse social and mental health outcomes.

The ability to accurately identify and label emotions in the self and others is crucial for successful social interactions and good mental health. In the current study we tested the longitudinal relationship between early language skills and recognition of facial and vocal emotion cues in a representative UK population cohort with diverse language and cognitive skills (N = 369), including a large sample of children that met criteria for Developmental Language Disorder (DLD, N = 97). Language skills, but not non-verbal cognitive ability, at age 5–6 predicted emotion recognition at age 10–12. Children that met the criteria for DLD showed a large deficit in recognition of facial and vocal emotion cues. The results highlight the importance of language in supporting identification of emotions from non-verbal cues. Impairments in emotion identification may be one mechanism by which language disorder in early childhood predisposes children to later adverse social and mental health outcomes.

Long-term outcomes of repaired and unrepaired truncus arteriosus: 20-year, single-center experience in Thailandhttps://peerj.com/articles/91482020-05-122020-05-12Ekkachai DangrungrojChodchanok VijarnsornPrakul ChanthongPaweena ChungsomprasongSupaluck KanjanauthaiKritvikrom DurongpisitkulJarupim SoongswangKriangkrai TantiwongkosriThaworn SubtaweesinSomchai Sriyoschati
Background
Truncus arteriosus (TA) is a complex congenital heart disease that carries morbidities in the first year of life. Previous authors have reported an operative mortality of 50%. In this report, we aim to report on the survival of patients with TA in our medical center in the recent era.
Methods
A retrospective review of all patients diagnosed with TA in Siriraj Hospital, Thailand from August 1995 to March 2018 was performed. Patients with single ventricle, hemiTA were excluded. The characteristics and outcomes of repaired and unrepaired TA patients with a known recent functional status in 2018 were reviewed. Operative mortality risks were analyzed using a multivariate model.
Results
A total of 74 patients (median age at referral: 70 days) were included in the cohort. One-third of the patients had associated anomalies including DiGeorge syndrome (13.5%). Anatomical repair was not performed in 22 patients (29.7%). The median age at time of repair for the 52 patients was 133 days (range: 22 days to 16.7 years). Complex TA was 10%. Early mortality occurred in 16 patients (30.8%). Five patients (9.6%) had late deaths at 0.3–1.2 years. Significant mortality risk was weight at time of operation <4 kg (HR 3.05, 95% CI [1.05–8.74], p-value 0.041). Of the 31 operation survivors, 17 required re-intervention within 0.4–11.4 years. Eight patients had reoperation at 8.7 years (range: 2.7–14.6 years) post-repair. Freedom from reoperation was 93%, 70.4%, and 31%, at 5, 10, and 15 years, respectively. All late survivors were in functional class I–II. Of the 22 unrepaired TA patients, 11 patients (50%) died (median age: 13.6 years; range: 14 days–32.8 years). Survival of unrepaired TA patients was 68.2%, 68.2%, and 56.8, at 5, 10, and 15 years of age, respectively. At the end of study, 11 survivors of TA with palliative treatment had a recent mean oxygen saturation value of 84.1 ± 4.8% and a mean weight for height of 81.4 ± 12.7%, which were significantly lower than those of 31 late-survivors who had undergone anatomical repair.
Conclusion
Contemporary survival rates of patients with TA following operation in the center has been gradually improved over time. Most of the operative mortality occurs in the early postoperative period. Compared to patients with TA who had palliative treatment, operative survivors have a better functional status even though they carry a risk for re-intervention.

Background

Truncus arteriosus (TA) is a complex congenital heart disease that carries morbidities in the first year of life. Previous authors have reported an operative mortality of 50%. In this report, we aim to report on the survival of patients with TA in our medical center in the recent era.

Methods

A retrospective review of all patients diagnosed with TA in Siriraj Hospital, Thailand from August 1995 to March 2018 was performed. Patients with single ventricle, hemiTA were excluded. The characteristics and outcomes of repaired and unrepaired TA patients with a known recent functional status in 2018 were reviewed. Operative mortality risks were analyzed using a multivariate model.

Results

A total of 74 patients (median age at referral: 70 days) were included in the cohort. One-third of the patients had associated anomalies including DiGeorge syndrome (13.5%). Anatomical repair was not performed in 22 patients (29.7%). The median age at time of repair for the 52 patients was 133 days (range: 22 days to 16.7 years). Complex TA was 10%. Early mortality occurred in 16 patients (30.8%). Five patients (9.6%) had late deaths at 0.3–1.2 years. Significant mortality risk was weight at time of operation <4 kg (HR 3.05, 95% CI [1.05–8.74], p-value 0.041). Of the 31 operation survivors, 17 required re-intervention within 0.4–11.4 years. Eight patients had reoperation at 8.7 years (range: 2.7–14.6 years) post-repair. Freedom from reoperation was 93%, 70.4%, and 31%, at 5, 10, and 15 years, respectively. All late survivors were in functional class I–II. Of the 22 unrepaired TA patients, 11 patients (50%) died (median age: 13.6 years; range: 14 days–32.8 years). Survival of unrepaired TA patients was 68.2%, 68.2%, and 56.8, at 5, 10, and 15 years of age, respectively. At the end of study, 11 survivors of TA with palliative treatment had a recent mean oxygen saturation value of 84.1 ± 4.8% and a mean weight for height of 81.4 ± 12.7%, which were significantly lower than those of 31 late-survivors who had undergone anatomical repair.

Conclusion

Contemporary survival rates of patients with TA following operation in the center has been gradually improved over time. Most of the operative mortality occurs in the early postoperative period. Compared to patients with TA who had palliative treatment, operative survivors have a better functional status even though they carry a risk for re-intervention.

The relationship between adolescent obesity and pelvis dimensions in adulthood: a retrospective longitudinal studyhttps://peerj.com/articles/89512020-05-112020-05-11Jan M. NovakJaroslav BruzekHana ZamrazilovaMarketa VankovaMartin HillPetr Sedlak
Background
The effect of fat tissue on a developing individual is fundamentally different from the effect on an adult. Several changes caused by obesity during sexual maturation have an irreversible and severe negative effect (lower fertility, reduced final height, type 2 diabetes mellitus) even for those who have subsequently lost weight. Our study was focused on monitoring the skeletal structure substantially influenced by sex hormones—the pelvis. The adult pelvis is strongly sexually dimorphic, which is not the case for the juvenile pelvis; skeletal differences between sexes are not so prominent and start to manifest with the onset of puberty. Evidence from animal models and case studies of treatment of gender dysphoria suggests that estrogens have a stimulatory effect on the growth plates present on the pelvis, leading to morphological change. Male obesity, especially in puberty, is connected with hypogonadism, manifesting in low levels of testosterone, and high levels of estrogens. The goal of our study was to evaluate the influence of obesity during adolescence on the morphology of the adult pelvis in the context of androgen and estrogen status.
Sample and Methods
Our sample consists of 238 individuals (144 females, 94 males) observed after an 8 year follow-up (mean age during enrollment 15.2 years, follow-up 23.3 years). Anthropometry and body composition using bioimpedance analysis (BIA) were obtained. During the follow-up, saliva samples from male participants were also collected to estimate testosterone and estradiol levels using the salivary ELISA kit (Salimetrics LLC, State College, PA, USA).
Results
The body fat (percentage of body fat estimated using BIA) was strongly positively associated with relative pelvic breadths in adulthood (males r = 0.64; females r = 0.56, both with p < 0.001). Adulthood pelvic breadth was a highly sensitive (0.81) and specific (0.74) retrospective marker of obesity during adolescence. The complex regression model (with reduction of dimensionality) including testosterone, estradiol to testosterone ratio and body fat (adolescent and adulthood) was able to describe 54.8% variability of pelvic breadth among males.
Discussion
We observed that adults with a history of obesity from adolescence tend to have a wider dimension of the bony pelvis in adulthood. Based on the parameters of the adult pelvis, the history of obesity can be determined with satisfactory sensitivity and specificity (<70%). One of the explanations for this observation can be the influence of relatively elevated estrogens levels connected with excessive adiposity leading to a wider pelvis. However, the biomechanical stress connected with elevated body mass also has to be considered, as does the influence of physical activity and gait pattern on the skeletal build.

Background

The effect of fat tissue on a developing individual is fundamentally different from the effect on an adult. Several changes caused by obesity during sexual maturation have an irreversible and severe negative effect (lower fertility, reduced final height, type 2 diabetes mellitus) even for those who have subsequently lost weight. Our study was focused on monitoring the skeletal structure substantially influenced by sex hormones—the pelvis. The adult pelvis is strongly sexually dimorphic, which is not the case for the juvenile pelvis; skeletal differences between sexes are not so prominent and start to manifest with the onset of puberty. Evidence from animal models and case studies of treatment of gender dysphoria suggests that estrogens have a stimulatory effect on the growth plates present on the pelvis, leading to morphological change. Male obesity, especially in puberty, is connected with hypogonadism, manifesting in low levels of testosterone, and high levels of estrogens. The goal of our study was to evaluate the influence of obesity during adolescence on the morphology of the adult pelvis in the context of androgen and estrogen status.

Sample and Methods

Our sample consists of 238 individuals (144 females, 94 males) observed after an 8 year follow-up (mean age during enrollment 15.2 years, follow-up 23.3 years). Anthropometry and body composition using bioimpedance analysis (BIA) were obtained. During the follow-up, saliva samples from male participants were also collected to estimate testosterone and estradiol levels using the salivary ELISA kit (Salimetrics LLC, State College, PA, USA).

We observed that adults with a history of obesity from adolescence tend to have a wider dimension of the bony pelvis in adulthood. Based on the parameters of the adult pelvis, the history of obesity can be determined with satisfactory sensitivity and specificity (<70%). One of the explanations for this observation can be the influence of relatively elevated estrogens levels connected with excessive adiposity leading to a wider pelvis. However, the biomechanical stress connected with elevated body mass also has to be considered, as does the influence of physical activity and gait pattern on the skeletal build.

School self-efficacy is affected by gender and motor skills: findings from an Italian studyhttps://peerj.com/articles/89492020-04-292020-04-29Roberto CodellaMariangela Valentina PuciMatteo VandoniLuca CorrealeChristel GalvaniFabio TogniFrancesco CasoloAlberto PassiClaudio OrizioGiampietro AlbertiFabio EspositoCristina MontomoliAntonio La Torre
Background
Perceived school self-efficacy (SE) is an important variable in students’ activities as it affects their motivation and learning. Further, self-efficacy might represent a good predictor of performance, persistence and perseverance. Motor skills and other physical health determinants are extensively debated and linked to cognitive function in children of developmental age. However, inconclusive evidence supports a definitive relationship between perceived school SE and motor skills among schoolchildren. We conducted a cross-sectional study on 6–11-year-old schoolchildren to evaluate the extent by which perceived school SE and physical health determinants were related.
Methods
A SE questionnaire and motor performance battery tests were administered to primary school pupils recruited from 154 sampled schools of northwest Italy. Perceived SE at school was assessed via 12 items from the Caprara’s questionnaire. Motor performance scores were obtained from motor skill tests: 4 × 10 m shuttle run test, SRT; standing broad jump, SBJ; six-minute walking test, 6MWT.
Results
A total of 3,962 children (M = 2,019; F = 1943) were studied and 68% were normal weight. Overall, a 58% of the sample perceived a high SE, while, as to gender differences, a greater percentage of females perceived high levels of school SE with respect to any other level (χ2 = 38.93, p < 0.0001). Results from multinomial logistic regression analysis revealed that: (i) females perceived higher SE compared to males; (ii) children who performed better in SRT and 6MWT showed higher levels of perceived school SE; (iii) no significant effect was registered for the body weight. Alternative strategies are encouraged to enhance SE through physical education: structured interventions might enhance both complex motor skills and high-order cognitive skills, like SE, in young children.

Background

Perceived school self-efficacy (SE) is an important variable in students’ activities as it affects their motivation and learning. Further, self-efficacy might represent a good predictor of performance, persistence and perseverance. Motor skills and other physical health determinants are extensively debated and linked to cognitive function in children of developmental age. However, inconclusive evidence supports a definitive relationship between perceived school SE and motor skills among schoolchildren. We conducted a cross-sectional study on 6–11-year-old schoolchildren to evaluate the extent by which perceived school SE and physical health determinants were related.

A total of 3,962 children (M = 2,019; F = 1943) were studied and 68% were normal weight. Overall, a 58% of the sample perceived a high SE, while, as to gender differences, a greater percentage of females perceived high levels of school SE with respect to any other level (χ2 = 38.93, p < 0.0001). Results from multinomial logistic regression analysis revealed that: (i) females perceived higher SE compared to males; (ii) children who performed better in SRT and 6MWT showed higher levels of perceived school SE; (iii) no significant effect was registered for the body weight. Alternative strategies are encouraged to enhance SE through physical education: structured interventions might enhance both complex motor skills and high-order cognitive skills, like SE, in young children.

Artificial intelligence system can achieve comparable results to experts for bone age assessment of Chinese children with abnormal growth and developmenthttps://peerj.com/articles/88542020-04-012020-04-01Fengdan WangXiao GuShi ChenYongliang LiuQing ShenHui PanLei ShiZhengyu Jin
Objective
Bone age (BA) is a crucial indicator for revealing the growth and development of children. This study tested the performance of a fully automated artificial intelligence (AI) system for BA assessment of Chinese children with abnormal growth and development.
Materials and Methods
A fully automated AI system based on the Greulich and Pyle (GP) method was developed for Chinese children by using 8,000 BA radiographs from five medical centers nationwide in China. Then, a total of 745 cases (360 boys and 385 girls) with abnormal growth and development from another tertiary medical center of north China were consecutively collected between January and October 2018 to test the system. The reference standard was defined as the result interpreted by two experienced reviewers (a radiologist with 10 years and an endocrinologist with 15 years of experience in BA reading) through consensus using the GP atlas. BA accuracy within 1 year, root mean square error (RMSE), mean absolute difference (MAD), and 95% limits of agreement according to the Bland-Altman plot were statistically calculated.
Results
For Chinese pediatric patients with abnormal growth and development, the accuracy of this new automated AI system within 1 year was 84.60% as compared to the reference standard, with the highest percentage of 89.45% in the 12- to 18-year group. The RMSE, MAD, and 95% limits of agreement of the AI system were 0.76 years, 0.58 years, and −1.547 to 1.428, respectively, according to the Bland-Altman plot. The largest difference between the AI and experts’ BA result was noted for patients of short stature with bone deformities, severe osteomalacia, or different rates of maturation of the carpals and phalanges.
Conclusions
The developed automated AI system could achieve comparable BA results to experienced reviewers for Chinese children with abnormal growth and development.

Objective

Bone age (BA) is a crucial indicator for revealing the growth and development of children. This study tested the performance of a fully automated artificial intelligence (AI) system for BA assessment of Chinese children with abnormal growth and development.

Materials and Methods

A fully automated AI system based on the Greulich and Pyle (GP) method was developed for Chinese children by using 8,000 BA radiographs from five medical centers nationwide in China. Then, a total of 745 cases (360 boys and 385 girls) with abnormal growth and development from another tertiary medical center of north China were consecutively collected between January and October 2018 to test the system. The reference standard was defined as the result interpreted by two experienced reviewers (a radiologist with 10 years and an endocrinologist with 15 years of experience in BA reading) through consensus using the GP atlas. BA accuracy within 1 year, root mean square error (RMSE), mean absolute difference (MAD), and 95% limits of agreement according to the Bland-Altman plot were statistically calculated.

Results

For Chinese pediatric patients with abnormal growth and development, the accuracy of this new automated AI system within 1 year was 84.60% as compared to the reference standard, with the highest percentage of 89.45% in the 12- to 18-year group. The RMSE, MAD, and 95% limits of agreement of the AI system were 0.76 years, 0.58 years, and −1.547 to 1.428, respectively, according to the Bland-Altman plot. The largest difference between the AI and experts’ BA result was noted for patients of short stature with bone deformities, severe osteomalacia, or different rates of maturation of the carpals and phalanges.

Conclusions

The developed automated AI system could achieve comparable BA results to experienced reviewers for Chinese children with abnormal growth and development.

Performances of the Canadian Agility and Movement Skill Assessment (CAMSA), and validity of timing components in comparison with three commonly used agility tests in Chinese boys: an exploratory studyhttps://peerj.com/articles/87842020-03-232020-03-23Yue CaoChunhua ZhangRong GuoDandan ZhangShijiao Wang
Background
The practical application of the Canadian Agility and Movement Skill Assessment (CAMSA) has been reported in some Western countries. However, a few studies reported the application of the CAMSA in Chinese children. In addition, given that the CAMSA was designing to incorporate both movement skills and agility assessment, the value and validity of the timing component of the CAMSA are worth discussing.
Methods
By choosing the Illinois Agility Test, Repeated Side Step-1 m distance, and the newly designed Repeated Side Step-half of height as the benchmark, we evaluate the performance of the CAMSA, further establish the concurrent validity of the CAMSA timing components (completion time and time score). In total, 149 male children (mean age 9.0 ± 0.8 years) from public schools in Shanghai, China, participated in the study.
Results
The mean CAMSA completion time was 19.3 ± 5.3 (s), and mean time score was 8.7 ± 3.9 (range of 1–14) for all participants (n = 149). After adjusted the sprint speed, older age was positively associated with the performance of the CAMSA. Being overweight was not associated with the performance of the CAMSA comparing with healthy body mass children, however, being obese was negatively associated with the CAMSA timing components and total score. Children having extracurricular sports activities (e.g., athletic experiences), mostly soccer, were more likely to demonstrated better performances of the CAMSA completion time, time score and total score. However, overweight and obese, also athletic experiences were not significantly contributed to the CAMSA skill score, although the association was slight (Adj R2 = 0.13). Besides, the CAMSA completion time has a strong correlation with the IAT, r = 0.77; RSS-1MD, r = − 0.76; and RSS-HHD, r = − 0.77, p < 0.01. The same pattern of correlation was also found between the CAMSA time score and three agility tests: IAT, r = − 0.79; RSS-1MD, r = 0.76; RSS-HHD, r = 0.78, p < 0.01.
Discussion
Overall, a few participants in the study were able to reach the recommended level of the total CAMSA score referring to the Canadian criterion. The strong concurrent validity was found between the CAMSA timing components and three selected agility tests, respectively.

Background

The practical application of the Canadian Agility and Movement Skill Assessment (CAMSA) has been reported in some Western countries. However, a few studies reported the application of the CAMSA in Chinese children. In addition, given that the CAMSA was designing to incorporate both movement skills and agility assessment, the value and validity of the timing component of the CAMSA are worth discussing.

Methods

By choosing the Illinois Agility Test, Repeated Side Step-1 m distance, and the newly designed Repeated Side Step-half of height as the benchmark, we evaluate the performance of the CAMSA, further establish the concurrent validity of the CAMSA timing components (completion time and time score). In total, 149 male children (mean age 9.0 ± 0.8 years) from public schools in Shanghai, China, participated in the study.

Results

The mean CAMSA completion time was 19.3 ± 5.3 (s), and mean time score was 8.7 ± 3.9 (range of 1–14) for all participants (n = 149). After adjusted the sprint speed, older age was positively associated with the performance of the CAMSA. Being overweight was not associated with the performance of the CAMSA comparing with healthy body mass children, however, being obese was negatively associated with the CAMSA timing components and total score. Children having extracurricular sports activities (e.g., athletic experiences), mostly soccer, were more likely to demonstrated better performances of the CAMSA completion time, time score and total score. However, overweight and obese, also athletic experiences were not significantly contributed to the CAMSA skill score, although the association was slight (Adj R2 = 0.13). Besides, the CAMSA completion time has a strong correlation with the IAT, r = 0.77; RSS-1MD, r = − 0.76; and RSS-HHD, r = − 0.77, p < 0.01. The same pattern of correlation was also found between the CAMSA time score and three agility tests: IAT, r = − 0.79; RSS-1MD, r = 0.76; RSS-HHD, r = 0.78, p < 0.01.

Discussion

Overall, a few participants in the study were able to reach the recommended level of the total CAMSA score referring to the Canadian criterion. The strong concurrent validity was found between the CAMSA timing components and three selected agility tests, respectively.

Heeding the psychological concerns of young cancer survivors: a single-arm feasibility trial of CBT and a cognitive behavioral conceptualization of distresshttps://peerj.com/articles/87142020-03-192020-03-19Josefin HagströmMalin AnderMartin CernvallBrjánn LjótssonHenrik W. WimanLouise von EssenJoanne Woodford
Background
A subgroup of adolescent and young adult (AYA) survivors of cancer during adolescence report high levels of psychological distress. To date, evidence-based psychological interventions tailored to the cancer-related concerns experienced by this population are lacking. The present study aimed to (1) examine the feasibility and preliminary efficacy of an individualized cognitive behavioral therapy (CBT) intervention for AYA survivors of cancer during adolescence; and (2) identify and conceptualize cancer-related concerns as well as maintaining factors using cognitive-behavioral theory.
Methods
A single-arm trial, whereby AYA survivors of cancer during adolescence (aged 17–25 years) were provided individualized face-to-face CBT at a maximum of 15 sessions. Clinical outcomes were assessed at baseline, post-intervention, and three-month follow-up. Intervention uptake, retention, intervention delivery, and reliable change index scores were examined. An embedded qualitative study consisted of two unstructured interviews with each participant pre-intervention. Along with individual behavioral case formulations developed to guide the intervention, interview data was analyzed to identify and conceptualize cancer-related concerns and potential maintaining factors.
Results
Ten out of 213 potential participants invited into the study were included, resulting in an overall participation rate of 4.7%. Nine participants completed the intervention, with respectively seven and eight participants completing the post-intervention and three month follow-up assessment. The majority of reported cancer-related concerns and maintaining factors were conceptualized into four themes: social avoidance, fear of emotions and bodily symptoms, imbalance in activity, and worry and rumination.
Conclusions
Given significant recruitment difficulties, further research is required to examine barriers to help-seeking in the AYA cancer survivor population. However, the conceptualization of cancer-related concerns and maintaining factors experienced by the population may represent an important first step in the development of psychological support tailored toward AYA cancer survivors’ unique needs.

Background

A subgroup of adolescent and young adult (AYA) survivors of cancer during adolescence report high levels of psychological distress. To date, evidence-based psychological interventions tailored to the cancer-related concerns experienced by this population are lacking. The present study aimed to (1) examine the feasibility and preliminary efficacy of an individualized cognitive behavioral therapy (CBT) intervention for AYA survivors of cancer during adolescence; and (2) identify and conceptualize cancer-related concerns as well as maintaining factors using cognitive-behavioral theory.

Methods

A single-arm trial, whereby AYA survivors of cancer during adolescence (aged 17–25 years) were provided individualized face-to-face CBT at a maximum of 15 sessions. Clinical outcomes were assessed at baseline, post-intervention, and three-month follow-up. Intervention uptake, retention, intervention delivery, and reliable change index scores were examined. An embedded qualitative study consisted of two unstructured interviews with each participant pre-intervention. Along with individual behavioral case formulations developed to guide the intervention, interview data was analyzed to identify and conceptualize cancer-related concerns and potential maintaining factors.

Results

Ten out of 213 potential participants invited into the study were included, resulting in an overall participation rate of 4.7%. Nine participants completed the intervention, with respectively seven and eight participants completing the post-intervention and three month follow-up assessment. The majority of reported cancer-related concerns and maintaining factors were conceptualized into four themes: social avoidance, fear of emotions and bodily symptoms, imbalance in activity, and worry and rumination.

Conclusions

Given significant recruitment difficulties, further research is required to examine barriers to help-seeking in the AYA cancer survivor population. However, the conceptualization of cancer-related concerns and maintaining factors experienced by the population may represent an important first step in the development of psychological support tailored toward AYA cancer survivors’ unique needs.

Non-ambulatory children with cerebral palsy: effects of four months of static and dynamic standing exercise on passive range of motion and spasticity in the hiphttps://peerj.com/articles/85612020-03-172020-03-17Åsa B. TornbergKatarina Lauruschkus
Purpose
The aim of this study was to compare the effects of four months of two types of structured training regimes, static standing (StS) versus dynamic standing (DyS), on passive range of motion (PROM) and spasticity in the hip among non-ambulatory children with cerebral palsy.
Method
Twenty non-ambulatory children with cerebral palsy participated in an exercise intervention study with a crossover design. During StS, the Non-ambulatory children with cerebral palsy were encouraged to exercise according to standard care recommendations, including daily supported StS for 30–90 min. During DyS, daily exercise for at least 30 min at a speed between 30 and 50 rpm in an Innowalk (Made for movement, Norway) was recommended. We assessed adaptive effects from the exercise programs through PROM in the hip assessed with a handheld goniometer, and spasticity in the hip assessed with the Modified Ashworth Scale before and after 30 min of StS or DyS. A trained physiotherapist performed the assessments. The exercise test and exercise training were performed in the children’s habitual environment. Non-parametric statistics were used and each leg was used as its own control.
Result
PROM increased in all directions after 30 min (p < 0.001), and after four months of exercise training (p < 0.001) of DyS. Thirty minutes of DyS lowered the spasticity in the muscles around the hip (p < 0.001) more than 30 min of StS (p < 0.001).
Conclusion
Thirty minutes of DyS increased PROM and decreased spasticity among non-ambulatory children with CP. Four months of DyS increased PROM but did not decrease spasticity. These results can help inform individualised standing recommendations.

Purpose

The aim of this study was to compare the effects of four months of two types of structured training regimes, static standing (StS) versus dynamic standing (DyS), on passive range of motion (PROM) and spasticity in the hip among non-ambulatory children with cerebral palsy.

Method

Twenty non-ambulatory children with cerebral palsy participated in an exercise intervention study with a crossover design. During StS, the Non-ambulatory children with cerebral palsy were encouraged to exercise according to standard care recommendations, including daily supported StS for 30–90 min. During DyS, daily exercise for at least 30 min at a speed between 30 and 50 rpm in an Innowalk (Made for movement, Norway) was recommended. We assessed adaptive effects from the exercise programs through PROM in the hip assessed with a handheld goniometer, and spasticity in the hip assessed with the Modified Ashworth Scale before and after 30 min of StS or DyS. A trained physiotherapist performed the assessments. The exercise test and exercise training were performed in the children’s habitual environment. Non-parametric statistics were used and each leg was used as its own control.

Result

PROM increased in all directions after 30 min (p < 0.001), and after four months of exercise training (p < 0.001) of DyS. Thirty minutes of DyS lowered the spasticity in the muscles around the hip (p < 0.001) more than 30 min of StS (p < 0.001).

Conclusion

Thirty minutes of DyS increased PROM and decreased spasticity among non-ambulatory children with CP. Four months of DyS increased PROM but did not decrease spasticity. These results can help inform individualised standing recommendations.

The role of age, sex, anthropometry, and body composition as determinants of physical fitness in nonobese children aged 6–12https://peerj.com/articles/86572020-03-172020-03-17Chiara MilaneseMarco SandriValentina CavedonCarlo Zancanaro
Purpose
The determinants of physical fitness in children have been given limited attention. In particular, the relative role of chronological age, sex, anthropometry, and body composition in physical fitness of children has been barely investigated. This cross-sectional study investigated determinants of physical fitness using a set of predictive variables including, in addition to chronological age and sex, a large panel of anthropometric measurements as well as body composition. The study was carried out in a convenience sample of children aged 6–12 participating in a summer camp.
Methods
One-hundred-ninety-three children (128 males) fulfilled all requirements and entered analysis. Health-related physical fitness components (speed, muscular power and balance) were explored by means of field tests, namely the 30-m dash test for running speed, the standing long jump and the seated chest pass test for lower limbs and upper body muscular power, respectively, and the flamingo balance test for static balance. Determinants of physical fitness were investigated by regression analysis using chronological age, sex, anthropometry, and body composition in a hierarchical approach. To minimize the expected effect of collinearity in predictor variables, an original statistical approach using Random Forests analysis was adopted.
Results
Age predicted 45.2%, 43.6%, 35.6% and 25.6%; and sex 9.5%, 10.7%, 6.3% and 2.0% of variance in the 30-m dash, seated chest pass, standing long jump, and flamingo balance test, respectively. Anthropometry and body composition explained a limited or no percentage of variance. The adjusted R2 (root mean square error) was 0.61 (0.31 s), 0.45 (0.32 m), 0.58 (0.15 m) and 0.41 (0.75 logs) for the 30-m dash, seated chest pass, standing long jump, and flamingo balance test, respectively making these models useful when physical fitness tests are not feasible.
Conclusions
We highlighted the respective role of chronological age, sex, anthropometry, and body composition in physical fitness of children in the wide age range 6–12 years. Data confirm and expand on previous literature by showing with a strictly conservative statistical approach that chronological age is a main determinant of physical fitness of both boys and girls, sex playing a limited role. The role of anthropometry was even less important, and no role was found for body composition. These findings should be considered when planning/implementing motor development or physical education programs.

Purpose

The determinants of physical fitness in children have been given limited attention. In particular, the relative role of chronological age, sex, anthropometry, and body composition in physical fitness of children has been barely investigated. This cross-sectional study investigated determinants of physical fitness using a set of predictive variables including, in addition to chronological age and sex, a large panel of anthropometric measurements as well as body composition. The study was carried out in a convenience sample of children aged 6–12 participating in a summer camp.

Methods

One-hundred-ninety-three children (128 males) fulfilled all requirements and entered analysis. Health-related physical fitness components (speed, muscular power and balance) were explored by means of field tests, namely the 30-m dash test for running speed, the standing long jump and the seated chest pass test for lower limbs and upper body muscular power, respectively, and the flamingo balance test for static balance. Determinants of physical fitness were investigated by regression analysis using chronological age, sex, anthropometry, and body composition in a hierarchical approach. To minimize the expected effect of collinearity in predictor variables, an original statistical approach using Random Forests analysis was adopted.

We highlighted the respective role of chronological age, sex, anthropometry, and body composition in physical fitness of children in the wide age range 6–12 years. Data confirm and expand on previous literature by showing with a strictly conservative statistical approach that chronological age is a main determinant of physical fitness of both boys and girls, sex playing a limited role. The role of anthropometry was even less important, and no role was found for body composition. These findings should be considered when planning/implementing motor development or physical education programs.